Written by a parent, not a doctor. Nothing here is medical advice.

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Get ready to apply

Idaho Department of Health and Welfare

Non-Emergency Medical Transportation

What you get

Rides to covered medical appointments, or $0.30 a mile for approved travel in your own vehicle. Open now.

Who starts it
You, with a letter from your doctor
How it’s sent
Online, on their website
Your time
About 30 minutes, plus waiting for the letter
Last checked
Aug 28, 2026

Before you start, check you fit

  • Minor riders must follow adult-attendant, parental-consent, car-seat, and under-14 exemption rules.
  • Mileage reimbursement rules, submission deadlines, and any trip-specific ancillary assistance should be confirmed before travel.
  • MTM applies least-cost and closest-available-provider rules and may require a provider Level of Need form for a different transportation mode.

  1. Ask your doctor for the letterStart here. This is the part that takes the longest.

    Idaho Department of Health and Welfare needs 2 things from your doctor. Copy this message, or say it in person at the next visit.

    Hi [doctor’s name],

We’d like to apply to Idaho Department of Health and Welfare’s Non-Emergency Medical Transportation. They offer rides to covered medical appointments, or $0.30 a mile for approved travel in our own vehicle, and they are taking applications now.

They need 2 things from you: a letter and a signature on the form. Their form and instructions are here: https://healthandwelfare.idaho.gov/providers/managed-care-providers/about-non-emergency-medical-transportation-nemt

Could you write that when you have a chance? I can send you the link, or bring a printout to our next visit. Thank you for everything you do for us.

[your name] · [phone]
    Copying is the only thing this page does with your text. Nothing is saved.

  2. Fill in their applicationIt is on their website.

    Open their application ↗ Checked Aug 28, 2026

    What the form asks for

    Parental Consent Form
    Child�s First NameChild�s Last NameChild�s Medicaid NumberMy name isI am the parent, guardian or legal custodian ofPrint your nameHow are you related to the childYour signatureDate
    Level of Need Assessment Form · your care team fills this in
    Facility Fax#First Name, Last Name, Date of Birth, Patient Address, Medicaid ID, City, State, ZIP, PhoneCan the patient ambulate independently up to � mileDoes the patient use any of the following assistive devicesDoes the patient require assistance of trained personnel for safety to effectively use the assistive devicesDoes the patient require an attendant or escort for travel/assistive serviceCan the patient self-transfer from a wheelchairCan the patient remove themselves from unsafe situationsDo environmental factors like heat or cold affect the patient�s mobility during certain seasonsVision, hearing, alertness, confusion, or memory limitations affecting transportationDoes the patient have any mental/behavioral health limitations that would affect their ability to use a particular mode of transportationHigh-risk pregnancy complications and expected due dateTransportation limitation isAdditional CommentsPrinted Name and Credentials, Phone, Facility or Individual NPIMedical Professional Signature and Date
    Reimbursement Trip Log
    First Name, Last Name, Medicaid number, member address, city, state, ZIP, phoneMake payment to, date of birth, payment address, city, state, ZIP, phoneFor each Trip #1�#5: trip number, date, type, leg type, starting address, provider phone, provider name/title, and provider addressHealthcare Provider Signature for each tripI have completed this form and I verify that the information on this trip log is trueSignature of Member, Parent/Legal Guardian, or Representative

    Have ready

    • Appointment, provider, pickup, destination, and accommodation details.
    • Parental Consent Form when a minor will ride alone.

  3. Submit it on their websiteSend the letter with your application, or the way they ask.

    • Call MTM or use MTM Link at least two business days before a routine appointment with member and trip information ready.

After you send

Call MTM for urgent rides, late rides, mileage reimbursement questions, or minor-rider exemption review. If you have not heard back in two weeks, write and ask whether it arrived.

Full record, as published